IOM DHSC & MANX CARE

[Apple]

@John Wright is probably right, and more.

I am not that important, believe me ! I don't have any current influence over any operational or strategic matters so I don't see myself as a problem.  I would be being naive if I thought I had any solutions or answers, so I don't make any. I hear the complaints and frustrations that I experience myself, that I get involved with, and some posted on here. I do not make them up. They are real for those that theses things happen to.  I also listen to those who work in the services still.

However, In the vast territory and scope that is the DHSC / Manx Care one person's point of view makes not any difference at all. 

1 hour ago, John Wright said:

Begs why they left it in such a mess.

It does indeed. But in all fairness there was not the money, the access to extra resources, and the political will to make the changes that were necessary. That has changed. Good.

I am happy to keep my views to myself and self censure in future. Not a problem.

Edited October 18, 2021 by Apple
last extra bit -forgot it.

[quilp]

Don't do that, it's not called for. 

[Dr. Grumpy]

Some honest information from Manx Care; Finally!

[Blackajah]

Until 2007, patients were only sent for 4 or so weeks prior to their appointment which was far more efficient.    Then in 2007 the health minister determined that 'every patient leaving their hospital appt would have the letter for the next appt in their hand' thus forcing patients to be booked and sent for up to a year in advance!       Many efforts and suggestions for improvement (including reverting to this older method) have been made over the years but have always been either rejected by management.     

[Roger Mexico]

Regarding the Dr Tinwell case there's some interesting information just emerged from an FoI Request[1].  The request starts:

Dear Attorney General

First Deemster Andrew Corlett dismissed an appeal from the health department in July 2020. The Deemster was plainly not happy with the DHSC, which were represented by the Attorney Generals Chambers noting that the proceedings had merely increased costs.

Naturally the Attorney Generals Chambers should not be seen to be wasting tax payer’s money so in this respect please supply the following

Request and response are:

Your Question – Part 1:

The total cost to the tax payer in court costs advocates time ect that the Attorney Generals Chambers have incurred throughout all the various and long running employment tribunals and failed court cases relating to Dr Tinwell.

Our Response – Part 1:

The Attorney General’s Chambers does not record court costs for an advocate’s time: nor does the court itself raise any costs when determining cases before it. In the case to which you refer the High Court made an order that the Appellant (which was represented by advocates from the Attorney General’s Chambers but which was not itself the Attorney General’s Chambers) was ordered to pay the Respondent’s costs of appeal which were assessed in the amount of £10,000 plus VAT.

Your Question – Part 2:

The case has disappeared off the employment tribunal listings. I ask the Attorney Generals Chambers has the case with Dr Tinwell been settled out of court. In respect of this I do not ask for the settlement figures just confirmation that the case has been settled out of court for an undisclosed sum. As it is tax payers money openness and transparency should rightfully be shown, so I can see no reason for not disclosing what has been asked for

Our Response – Part 2:

For this part of your question, the Attorney General’s Chambers can confirm that prior to the proceedings before the Tribunal being determined, the parties disposed of matters relating to the dispute on what they both agreed were strictly confidential terms.

 

You can almost hear the gritted teeth the answer came through.  In any other organisation, saying that no records are kept of the time spent by very highly-paid staff would be treated as ridiculous (particularly as it's not unknown for the AG's Office to try to claim their costs against individuals), but this lot are so disorganised it might be true.

 

[1]  As ever the servlet problem means it can't be reliably linked but case ID is 2021153 and the title "Costs incurred in the Dr Tinwell court and employment tribunals" submitted on 04/10/2021 (replied on 19th)

[Gladys]

2 minutes ago, offshoremanxman said:

That was going to be my question. Surely in an action where costs are awarded then they would keep a record of time spent? Otherwise if they’re awarded costs if they’re successful what do they do? Just make some up? 

Doesn't the court assess costs, I think it is called taxing?  It doesn't matter what is actually spent, but what the court thinks is a reasonable amount to have spent.  So you can hire a lawyer at £1,000 per hour, but if you are awarded costs the court will apply a reasonable hourly rate for a reasonable number of hours.  You probably do have to prove the actual expenditure, but I don't think you automatically get it back. 

[Anyone]

In Europe , not me but a friend needed a doctor , face to face consultation within 30 minutes , pharmacy on site. Sorted. I’m not sure why the IOM or the UK can’t do that. 

[Anyone]

In Europe , not me but a friend needed a doctor , face to face consultation within 30 minutes , pharmacy on site. Sorted. I’m not sure why the IOM or the UK can’t do that. 

[Anyone]

Well we all know why , it’s the extreme left wing BMA.

[wrighty]

9 minutes ago, Anyone said:

In Europe , not me but a friend needed a doctor , face to face consultation within 30 minutes , pharmacy on site. Sorted. I’m not sure why the IOM or the UK can’t do that. 

Similar experience as a visitor to Australia. We paid, not too much. Perhaps that’s the answer?

[Anyone]

Could be , 20 Euros for the doctor which I thought was cheap and 70 euros for the antibiotics. All insured of course. So maybe a quasi private model for those who can insure / pay with free for those who can’t might just work better.

[wrighty]

40 minutes ago, Anyone said:

Could be , 20 Euros for the doctor which I thought was cheap and 70 euros for the antibiotics. All insured of course. So maybe a quasi private model for those who can insure / pay with free for those who can’t might just work better.

I agree, but I am worried about fully private care tending to over-treatment, and that means testing means that 90%+ of healthcare use will be free and that its administration will cost more than the savings. 
 

It’s a difficult nut to crack. 

[Anyone]

On 10/24/2021 at 11:19 PM, wrighty said:

I agree, but I am worried about fully private care tending to over-treatment, and that means testing means that 90%+ of healthcare use will be free and that its administration will cost more than the savings. 
 

It’s a difficult nut to crack. 

Hadn’t thought about the over treatment bit but I’m in my 60’s and last time I went to see the doc was 2015. So maybe a £10 charge might stop the malingerers , but maybe not. I checked out private in Europe and you can get decent basic cover for about €1,500. That’s for usual stuff not big time issues. I would think that quite a few of the population could afford that. Thing is I suppose , it’s free now so who would vote for that! Problem is what we have now in IOM/UK is not working too well. And of course the NHS is a political sacred cow. It’s perfect innit. So I suppose it will just carry on SNAFU.

[hampsterkahn]

The NHS is a huge  multi-layered organisation .

At its worst,  it is self-preserving,ponderously  slow and inefficient.

 Unfortunately though, no-one seems to have come up with anything anywhere near as good.

Since 1948, it has meant that If you were very ill, your treatment was provided. You didn’t need to be wealthy and able to pay, or have to beggar the next two generations of your family in order to meet the bills.

It does mean that we have been brought up in the comforting belief that  the NHS was a total system of care  from ,quote , “Cradle to Grave”.

The reality  is a surprise to many -It isn’t, and it never was.

For NHS  has never included Social Care -and specifically funding for looking after you when you are very old.

This is a crisis that is already here, and one no politician will rush to  wrestle.

 

 

 

 

 

Edited October 26, 2021 by hampsterkahn

[code99]

I was listening to a podcast the other day where somebody mentioned that in some parts of the USA a nurse working in a hospital could now, because of rampant wage inflation, earn $250,000 pa. Compared to this very fortunate US nurse, a senior nurse in the UK would be on a maximum £70,000 and have the added ‘benefit’ of getting occasional patient abuse as an unavoidable ‘perk’.  In Australia they have a mixed public and private health system. It is mandatory for anybody earning over a specific threshold to either sign up to a private health or pay higher Medicare levy. Nevertheless, their private health system is in crisis due to young people opting out of it, in droves, as they are finding that the ever-increasing premiums do not justify their potential ‘personal’ benefits. They prefer to pay extra Medicare levies instead. Unfortunately, these levies are still too low and it is only matter of time that the taxes must go up.

IMHO, if the Island introduces ‘fees’ for seeing GPs or similar, then this process should be handled cautiously, and should only be implemented if there is means-testing. I also suspect that the admin costs associated with managing such a system will probably outweigh any additional revenues it might generate.

Contrary to the prevailing myth that, because the IoM has one of the highest per capita income rates in the world, everybody on the Island is rich; the truth is that most residents are ordinary people with basic incomes. My view is that even the upcoming 27.5% increase in gas prices will be difficult for many residents to pay. Being hammered by GP fees would be a very unfair burden for a lot of people. One of two things are therefore likely to happen; either 1) people will skip their GPs appointments, something that could lead to more serious problems longer term, or 2) more and more people will pile into A&E (which is already stretched), whenever they need to see a doctor.

Other options must be sought, if we wish to retain a health system which is fair for everyone.